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Summary of Background Data: SDW is frequently observed after surgery; however, data about its mechanism and relations with outcome are limited.\nMethods: Data of 59 AIS patients with Lenke type 5 curves who underwent posterior spinal fusion to L3 as the lowest instrumented vertebra (LIV) were retrospectively analyzed. The subjacent disc angle (SDA) was defined as the angle between L3 (LIV) and L4. SDW was defined as the absolute value of SDA?10° at 2-year post-operation. The incidence of SDW was investigated between nonselective and selective thoracolumbar/lumbar (TL/L) fusion group. In the selective group, patients with and without SDW were compared.\nResults: Among 59 patients, 11 had nonselective and 48 had selective fusion. No patients in the non-selective group showed SDW vs 13 patients in the selective group (27%) showed SDW. 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Preoperative thoracic curve magnitude and L4 end vertebra were risk factors for subjacent disc wedging after selective thoracolumbar/lumbar fusion with L3 as the lowest instrumented vertebra in Lenke type 5 curve patients.
http://hdl.handle.net/10271/00004168
http://hdl.handle.net/10271/000041688b62c29b-2ea2-4efa-9f57-d665750ad5a4
名前 / ファイル | ライセンス | アクション |
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Spine-46-E878.pdf (1.1 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2022-08-08 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | Preoperative thoracic curve magnitude and L4 end vertebra were risk factors for subjacent disc wedging after selective thoracolumbar/lumbar fusion with L3 as the lowest instrumented vertebra in Lenke type 5 curve patients. | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | adolescent idiopathic scoliosis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | Lenke type 5 curves | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | subjacent disc wedging | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | coronal balance | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | main thoracic curve | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | lower instrumented vertebra | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | L3 vertebra | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
その他のタイトル | ||||||
その他のタイトル | Postoperative subjacent disc wedging | |||||
著者 |
Banno, Tomohiro
× Banno, Tomohiro× Yamato, Yu× Oba, Hiroki× Ohba, Tetsuro× Hasegawa, Tomohiko× Yoshida, Go× Arima, Hideyuki× Oe, Shin× Mihara, Yuki× Ushirozako, Hiroki× Takahashi, Jun× Haro, Hirotaka× Matsuyama, Yukihiro |
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書誌情報 |
Spine 巻 46, 号 16, p. E878-E887, 発行日 2021-08-15 |
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出版者 | ||||||
出版者 | Wolters Kluwer Health | |||||
権利 | ||||||
権利情報 | "This is a non-final version of an article published in final form in ""Spine; 46(16): pE878-E887, 2021""." | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Study Design: Retrospective multicenter study Objective: This study aimed to investigate the incidence and risk factors of subjacent disc wedging (SDW) in adolescent idiopathic scoliosis (AIS) patients with Lenke type 5 curve. Summary of Background Data: SDW is frequently observed after surgery; however, data about its mechanism and relations with outcome are limited. Methods: Data of 59 AIS patients with Lenke type 5 curves who underwent posterior spinal fusion to L3 as the lowest instrumented vertebra (LIV) were retrospectively analyzed. The subjacent disc angle (SDA) was defined as the angle between L3 (LIV) and L4. SDW was defined as the absolute value of SDA?10° at 2-year post-operation. The incidence of SDW was investigated between nonselective and selective thoracolumbar/lumbar (TL/L) fusion group. In the selective group, patients with and without SDW were compared. Results: Among 59 patients, 11 had nonselective and 48 had selective fusion. No patients in the non-selective group showed SDW vs 13 patients in the selective group (27%) showed SDW. In the selective group, patients with SDW showed significantly greater main thoracic (MT) curve, apical vertebral translation of the MT curve, upper instrumented vertebra tilt, LIV tilt, and SDA at 2 years post-operation, while no differences were found in the coronal balance nor clinical outcome. Multivariate analysis revealed preoperative T curve and SDA as predictors of SDW occurrence. T curve>30° and SDA>0° were calculated as cutoff values based on the receiver operating characteristic curve. Conclusions: SDW is sometimes seen in Lenke type 5 AIS patients who underwent selective TL/L fusion. SDW seemed to occur as a compensation mechanism for progressing deformity of unfused segments (thoracic curve and residual lumbar curve) to maintain coronal alignment. Preoperative T curve>30° and SDA>0° (LEV as L4) were determined as risk factors for SDW occurrence. |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 0362-2436 | |||||
EISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1528-1159 | |||||
PubMed番号 | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | PMID | |||||
関連識別子 | 33496533 | |||||
出版社DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1097/BRS.0000000000003961 | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa |